Understanding Dissociative Disorders & Addiction
Dissociative disorders are a group of psychiatric conditions characterized by disruptions in the normal integration of consciousness, memory, identity, emotion, perception, behavior, or control. Dissociation exists on a spectrum from normal, occasional experiences (such as daydreaming or the absorbed attention of "flow states") to severe, pathological disruptions (such as dissociative identity disorder, formerly known as multiple personality disorder). Clinically significant dissociation produces significant distress and functional impairment, with individuals experiencing depersonalization (feeling detached from their body), derealization (feeling that the world is unreal), memory gaps, identity confusion, and profound alterations in consciousness.
Dissociative disorders typically develop as adaptive responses to severe, overwhelming trauma, particularly childhood abuse. The brain's remarkable capacity for dissociation enables survival of unsurviviable experiences by allowing consciousness to separate from the traumatic events being experienced. However, the protective mechanism becomes pathological when the brain continues to default to dissociation long after the threat has passed. Individuals with dissociative disorders frequently use substances to manage their symptoms, seeking pharmacological dimming of the distressing alterations in consciousness and perception. Alcohol and benzodiazepines are commonly used to reduce dissociative symptoms, while dissociative drugs like ketamine or dextromethorphan may paradoxically appeal to individuals with dissociative disorders. Over time, substance use becomes intertwined with dissociative processes, complicating the clinical picture.
At Trust SoCal, our trauma-informed dual diagnosis program recognizes the deep connection between dissociation and addiction, providing specialized treatment that addresses trauma, stabilizes dissociative symptoms, and treats the substance use disorder within an integrated framework.